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Normal Plasma Cholesterol in an 88-Year-Old Man Who Eats 25 Eggs a Day

41 points| argumentum | 13 years ago |nejm.org | reply

54 comments

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[+] JPKab|13 years ago|reply
Current state of nutritional science: Propose hypothesis of heart diseased caused by high consumption of animal fats

Tell public to reduce animal fat consumption to reduce heart disease

Public reduces animal fat consumption

Heart disease rates continue to stay the same

Conduct studies to prove old hypothesis isn't wrong: Studies show that Atkins style diets have closer to optimal HDL/LDL/Triglyceride blood levels than low fat diets

Ignore study

Claim that it must be genetics that causes "some" people to not get heart disease from high fat, low carb diets

Watch the documentary "Fathead" on Netflix. The movie can be a little annoying in its political overtones, but the fact that the guy eats an extremely high fat diet with low carb and sugar intakes and improves his cholesterol numbers is interesting. Of course, it must be a genetic fluke, according to the low fat promoters. Let's do the math, shall we:

Odds of a person having a genetic mutation where they are immune to cholesterol when most people aren't: low

Odds of a person choosing to make a documentary: low

Odds of a person choosing to make a documentary about themselves going on an extremely high fat diet for 30 days: extremely low

Odds that this same person just happens to be one of these people who is genetically immune to cholesterol....... REALLY?

[+] mberning|13 years ago|reply
Actually 'Heart disease rates continue to stay the same' should be changed to 'increased'

In addition to heart disease there is a whole bevy of metabolic disorders that are on the rise (type 2 diabetes, hypertension, PCOS, fatty liver, etc.)

In the 80s the government told us to reduce our fat and cholesterol intake, and research shows that we did a bang up job of reducing it. But why are we continuing to get sicker and fatter?

The nutritional recommendations of the US and most of the world has to be one of the larges and most unethical experiments of all time.

[+] colanderman|13 years ago|reply
While I agree with the sentiment of your comment, this reasoning is greatly flawed:

Odds of a person having a genetic mutation where they are immune to cholesterol when most people aren't: low

Odds of a person choosing to make a documentary: low

Odds of a person choosing to make a documentary about themselves going on an extremely high fat diet for 30 days: extremely low

Odds that this same person just happens to be one of these people who is genetically immune to cholesterol....... REALLY?

You have calculated the odds of any given individual creating a documentary about going on a high-fat diet and having a genetic mutation. However the claim you are trying to refute is that this particular individual has a genetic mutation. Since this particular individual is known to have made a documentary about themselves going on a high-fat diet, you must instead look at the conditional probability.

It is likely that making a documentary about going on a high-fat diet is totally uncorrelated with having a genetic mutation. This means that the probability of this person making a documentary about going on a high-fat diet is divided out of the final probability, which reduces simply to the probability that they have a genetic mutation.

Of course it could be possible that making such a documentary is negatively correlated with having a mutation, in which case your point stands. However I highly doubt this is the case.

However it could also be the case that making such a documentary is positively correlated with having a mutation, in which case your point is moot. It is more likely that this is the case, as this particular individual may have known beforehand that his body dealt well with fat; also, other individuals may have made a similar documentary but never published it because the outcome (getting fat) was as expected.

[+] drucken|13 years ago|reply
Fat Head (2009)

BBC Horizon: Why Are Thin People Not Fat? (2009)

- both very interesting programmes that contain surprising amount of cutting edge scientific information.

- both demonstrate how the Lipid Hypothesis has effectively been debunked and it is only now that it has taken 40+ years for this to edge into mainstream, despite copious anectodal and historical evidence to the contrary.

- Fat Head, in particular, also attempts to explain why this enormous gap in science even exists.

[+] steve8918|13 years ago|reply
I absolutely agree.

The problem these days is that easily digestible theories are now taken for fact. Because it's easy to digest and easy to transmit, they get spread very easily by the general population, even though they don't make sense.

"Eat fat, and your body turns that into fat. If you want to lose weight, then stop eating fat."

The funny thing is how violently people react when you explain to them that those theories are possibly wrong. My friend is "trying" to lose weight by cutting out the fat. When I tell her that she needs to cut carbs instead, she gets almost offended, and says that it doesn't work. Meanwhile, I lost 20 lbs in 5 months while on an aggressive South Beach diet (less than 100 g of carbs per day) and my cholesterol was extremely low.

When you look into the actual biochemistry of it, it really looks like the pathways that Atkins/South Beach diet talk about with respect to carbohydrates and blood sugar are the real culprits. The food we eat today is highly processed, and creates an over-balance of blood sugar, and that is the cause of why so many Americans are fat.

The food industry has found cheaper and more predictable ways of making our food (process the carbohydates into a fine powder, so that it's uniform and easy to cook with), but the side effect of this is that it causes our blood sugar to skyrocket and makes us fat because we are mostly sedentary (myself included).

The funny thing is that even the theories on cholesterol are coming into question. The absolute values of HDL/LDL may not be important, but some people are saying it's the ratio of HDL to LDL that matters. So companies like Pfizer that have been drugging people for years with Lipitor may just be extracting money from people with no real benefit.

[+] MPSimmons|13 years ago|reply
The big question is then, if consumption of animal fats isn't contributing to heart disease, then what's doing it?

We've found heart disease in Egyptian mummies, so it's been with us as long as paper has been. Is it merely a side-effect of living? Even swine have been found to have narrowing of the arteries (http://vet.sagepub.com/content/19/6/676.full.pdf).

If it's influenced by what we eat, can we change our diets and affect it, or is it entirely genetic? Do dietary changes affect it? If so, does anything reverse it?

I agree, animal fats don't appear to be the single cause, but if they aren't, what is?

[+] pivo|13 years ago|reply
Odds of someone choosing to make a documentary when they can dispute commonly accepted wisdom: pretty good

I haven't seen this documentary, maybe he started out thinking he'd prove that his diet was actually bad. If not, then I think it's pretty likely that this documentary was eventually made.

[+] carsongross|13 years ago|reply
Now generalize that state of affairs to science at large: it ain't just the nutritional scientists.
[+] Inufu|13 years ago|reply
To be fair, he might have decided to create this documentary precisely _because_ he has this mutation (I'm not saying that that's the reason why his cholesterol is low, or that this is good/bad), and therefore reacts abnormally to this diet.
[+] adventureful|13 years ago|reply
I find the China Study and Dr. Esselstyn's work to be far more interesting in regards to the results of a diet rich in the consumption of animal cholesterol and animal protein.
[+] nessus42|13 years ago|reply
I thought that it was debunked decades ago that dietary cholesterol significantly increases bad serum cholesterol (i.e., LDL). Dr. Agatston, the famous cardiologist who invented what is now the standard test for coronary calcification, certainly claims that there is no reason to avoid eating eggs. (I don't know what he'd say about 25 per day, but that can't be a very balanced diet!)
[+] yannk|13 years ago|reply
First oddity that jumped on my face is: why 25? 24 seems to be a much better number.
[+] ams6110|13 years ago|reply
Packaging eggs by the dozen is largely a consumer retail thing. Restaurants and commercial packing is more typically on a 5x5 square. Maybe he was getting his eggs from a wholesale supplier... at that rate of consumption it might make sense.
[+] jemka|13 years ago|reply
The article says "about 25 eggs per day".
[+] dxbydt|13 years ago|reply
Upvoted. Took me just a while to figure that one out.
[+] BadassFractal|13 years ago|reply
Nutritional science is indeed a nightmare to deal with, especially to discuss.

People still won't believe me when I tell them that they should at the very least try reducing their carb intake. It's surely possible that Good Calories Bad Calories, and the various Intermittent Fasting / Primal proponents are there are full of crap and don't know what they're talking about, but it has at the very least worked for me.

I went from 25+% fat a couple of years ago to about 8% now, shooting for 6-7% soon, and I'm barely at the gym a couple of days a week (I do lift heavy though). There's nothing quite like being really happy with one's shape after years of being really uncomfortable.

[+] soperj|13 years ago|reply
I have a carb heavy diet, and always have, but play alot of sports, and have always hovered in the 10% fat and below range.
[+] Lazare|13 years ago|reply
This is a surprise?

The idea that eating food that contains cholesterol magically increases the cholesterol levels in your blood never made any real sense, and has been debunked repeatedly.

(What does increase blood cholesterol? Fructose, mostly. If you're trying to control your cholesterol the maple syrup on your pancakes and - especially - that big glass of orange juice are killer. The eggs, by contrast, are good for you.)

[+] Raphael|13 years ago|reply
You have to admit it's counter-intuitive. Cholesterol in, low bad cholesterol levels; sugar in, high bad cholesterol levels.
[+] bbayer|13 years ago|reply
Couple of years ago I have lived in Korea for one month. Their daily food doesn't include produced salt, sugar and carbs. If you want salt you have to eat ocean algae. If you want sugar grab some fruit juice. Do you need carb, go get a steamed rice. Also they consume lots of gabbage usually in Kimchy form which I believe helps to decrease LDL levels. I know because after returned back my LDL levels were in normal levels. Normally I am suffering from high LDL.

In my experiments (on my own) I can say that walnut and stinging nettle also helps to lower bad cholesterol. (btw I don't have medical profession, don't get this as advice.)

I saw lots of people who eats animal fat all the time and have low levels of LDL. Even though I did diet, I couldn't maintain LDL in normal levels. I have to use medication. I believe it is highly related with genetic factors and somehow some people's body couldn't handle things as expected. A bug that we cannot fix. The only way is monkey patching.

[+] argumentum|13 years ago|reply
The line below made me check if the article was published on the first day of april.

""" The patient stated, "Eating these eggs ruins my life, but I can't help it."

[+] ktizo|13 years ago|reply
I'm glad they didn't try to see what would happen if he stopped eating eggs. At the age of 88, and given that he has done this solidly for so very long, they could accidentally kill him by putting him on a more average diet.

What would be extremely interesting is studying any genetic factors and whether they could have possibly even drove him to eat this amount of eggs just to keep his cholesterol levels high, and also, conversely, whether there is any biochemical adaptation, especially anything that is unusual for his genetic makeup, that helps him retain this level of cholesterol consumption without getting ill, that could have resulted from long term exposure to his diet or other environmental factors.

[+] abecedarius|13 years ago|reply
The paper did discuss adaptations, though in my skim I saw no sign of anything genetically unusual behind them -- afaik they left that open.
[+] autarch|13 years ago|reply
Cue the endless comments from unqualified nerds who are convinced they and they alone know everything about nutrition science, and that all the commonly accepted facts are totally wrong. Complete with links to random Youtube videos of some dude who proves them right.
[+] tzs|13 years ago|reply
Actually, they are not disagreeing with nutrition science. They are disagreeing with nutritionalism. And they are right (although some of the specific links might be replacing one kind of nutrisionalism with another).

Here's the difference. Nutrition science IS science. It's results come from controlled, replicable experiments, checked via peer review and analyzed correctly for significance.

Nutritionism is the belief that food is just the sum of independent nutrients and other substances, and once we know what nutrients we need we and which substances are bad, we can rearrange and pick and choose to get an ideal diet, coupled with the belief that we know enough from nutrition science to actually understand enough of nutrients and other food substances to actually do this.

Nutritionism IS NOT science. It is to nutritional science what pop psychology is to neurobiology.

Here are some examples (based on real things, but I do not have specific references handy so I'm going to keep the details generic). Suppose nutrition science finds that substance X is vital to health, and that carrots are high in substance X, and that people who eat a couple servings of carrots a week get enough substance X.

Synthesizing substance X (or extracting it from carrots) and adding it to to some other food, and then telling people that they can use that other food as a source of substance X is nutritionalism, not nutrition science. Or making X pills for people and telling them these can supply the X they are not getting from their diet is nutritionist, not nutrition science.

This is because it is possible that in order for our digestive system to actually extract and absorb substance X, it needs something else (substance Y) which is found in carrots, but is not found in those supplements or in the food that the synthetic X is added to--and so people getting X in the supplement or additive form are not actually making it available to their bodies.

The X supplements do not move from nutritionalism until scientists actually do the experiments and show that we can incorporate X in that form, or gain sufficient understanding of the mechanism by which X is absorbed to be able to say it will work in supplement form.

Another example: for almost everything we are told we must eat more of (fish, carbohydrates) or less of (red meat, carbohydrates, fats, cholesterol), there exists some culture for which (1) their traditional diet goes massively against that advice, and (2) people who eat that diet are healthy.

That's because the advice we get in these areas is NOT based on nutrition science. It is based on nutritionalism. The science that says that, say, red meat is bad for you ACTUALLY says that in particular studies of particular populations, red meat was bad. For people that strongly match the characteristics of the populations in those studies (e.g., whose complete diet is similar to the complete diet of the participants, and who live similar lifestyles) the conclusion that they should avoid red meat is probably pretty accurate. Since there are other populations in which red meat consumption does not appear to lead to those bad health effects, however, the proper conclusion is that the dire effects of red meat cannot be generalized outside of populations like the study populations.

Your best bet if you want to avoid nutritionalism is to try to stick to proven traditional diets. If the people of some region or culture have been eating a certain way for hundreds of years, and are in good health, that's pretty damn good evidence that their diet as a whole works. If someone's theory says that they should be in poor health because their diet includes too much X, or doesn't have enough Y, then that someone's theory is incomplete or wrong. In science, when results and theory disagree, results win.